Background: Menorrhagia is prolonged excessive menstruation that might be interfere with the woman's physical, emotional, social and material quality of life. It may be idiopathic or due to fibroids, adenomyosis, pelvic congestion and arterio-venous malformations or coagulation disorders. Objective: Evaluation of the effectiveness of uterine artery embolization in the management of refractory menorrhagia conserving the patient's fertility when other treatment options are not applicable. Patient and methods: This study was conducted between February 2011 and September 2015 on a total 7 female patients. The mean age was 35.4 + 3.7 years and age range  of between 28–42 years. This retrospective study was treating the patients with severe refractory menorrhagia not responding to medical treatment and have local uterine pathology {multiple fibroids, adenomyosis or arteriovenous malformation (AVM)} and requiring fertility preserving treatment option. They referred from the Gynecological clinic, Al-Azhar University Hospitals, Health insurance hospitals and Cairo health care centre, and selected to undergo uterine artery embolization (UAE). Results: Seven patients underwent UAE. Two (29%) patients experienced clinical failure; the first patient underwent hysterectomy due to development of infection and offensive vaginal discharge, and the second patient experienced no improvement treated by AVM re-embolization. After 6 months of follow-up, the overall clinical success rate was based on the cessation of bleeding which was 5 (72%) patients. Temporary amenorrhea was experienced for 6.5+ 2.6 months in 6 (86%) patients. The mean uterine fibroid diameter was 7.4 + 3.2 cm (range 1.8- 11.5) before UAE and decreased to 4.3+2.4 cm (range 1.2–7.5) 6 months after UAE. Conclusion: UAE is a percutaneous procedure that involves no general anesthesia, no surgical incision, and no blood loss or risk of blood transfusion. It can be used in refractory amenorrhea treatment and alternative to a hysterectomy, to conserve the uterine fertility. Recovery and time to return to work and daily living activities is relatively short.